Scenario
A previously well 23 year old man is brought to your Emergency Department acutely short of breath after developing left sided chest pain at work.
On arrival, he appeared pale and sweaty and was hypotensive.
A CXR was taken immediately after a procedure was performed to stabilise his condition. His vital signs are now normal.
Question
a. Describe and interpret his CXR (30%) b. Outline your treatment options (70%)
Answer
FACEM VAQ Exam 2009.1 – Question 2
- The overall pass rate for this question was 71/81 (87.7%)
- Chest X-ray showing a pneumothorax with needle thoracostomy catheter in situ and no evidence of radiological tension.
- The examiners viewed this as a good prop investigating a core emergent condition.
- Pass criteria were to identify the X-ray features, institute definitive drainage and organize appropriate inpatient disposition.
- Fail criteria included failure to adequately describe the X-ray, treating the remaining pneumothorax conservatively and sending the patient home.
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The question is bit vague… it says outline treatment options rather than management or just treatment .. i thought we were to discuss the options ie needle throacocentesis / Pig tail catheter / Formal chest drain.. etc
also thought there might a pneumo mediastinum ?? did any one else think so ??